MCSO/OSU-CHS

Service Evaluation by Resident

Rotation *

DATE OF ROTATION *

Resident Name

*

Instructor Name *

Overall Rotation Rating *

poor

average

good

excellent

Overall instructor rating *

poor

average

good

excellent

About the Rotation

(1=poor, 3=average, 5=excellent) *

	1	2	3	4	5
Was the rotational environment conducive to a good educational experience?	1	2	3	4	5
Were there scheduled formal educational programs?	1	2	3	4	5
Was the educational experience additive?	1	2	3	4	5
Did the educ.and service components complement?	1	2	3	4	5
Was the service pace appropriate?	1	2	3	4	5
Was your knowlege tested?	1	2	3	4	5
Did you have assignements?	1	2	3	4	5
Were assignments relevant?	1	2	3	4	5
Did you require reference texts?	1	2	3	4	5
Were reference texts or online materials avail.?	1	2	3	4	5

(1=poor, 3=average, 5=excellent) *

	1	2	3	4	5
Was the rotational environment conducive to a good educational experience?	1	2	3	4	5
Were there scheduled formal educational programs?	1	2	3	4	5
Was the educational experience additive?	1	2	3	4	5
Did the educ.and service components complement?	1	2	3	4	5
Was the service pace appropriate?	1	2	3	4	5
Was your knowlege tested?	1	2	3	4	5
Did you have assignements?	1	2	3	4	5
Were assignments relevant?	1	2	3	4	5
Did you require reference texts?	1	2	3	4	5
Were reference texts or online materials avail.?	1	2	3	4	5

(1=poor, 3=average, 5=excellent) *

	1	2	3	4	5
Supervisor was knowlegable	1	2	3	4	5
Supervisor was prompt and available	1	2	3	4	5
Supervisor was fair	1	2	3	4	5
Supervisor challenged you to learn	1	2	3	4	5
Supervisor gave you solid feedback	1	2	3	4	5

My medical knowlege increased because of this rotation *

yes

no

not sure

There was a balance between professional and personal life in this rotation *

yes

no

not sure

Suggested improvements for this rotation *